Does Education Improve Health? Evidence from Indonesia

Abstract

I examine the effects of education on health in Indonesia using an exogenous variation in education induced by an extension of Indonesia’s school term length in 1978–1979, a natural experiment that fits a regression discontinuity design. I find the longer school year increases educational attainment and wages, but I do not find evidence that education improves health. I explore some mechanisms through which education may affect health, but education does not seem to promote healthy lifestyles, increase the use of modern healthcare services, or improve access to health insurance; if anything, education improves only cognitive capacity.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

1. For literature reviews of the early studies, see Goldman (2001) and Grossman and Kaestner (1997).

2. The papers that use instrumental variable techniques use compulsory schooling laws, parental education, college expansions, unemployment rates, exemptions from military service, or draft lottery for the Vietnam war as instruments; they are, among others, Adams (2002), Arendt (2005), Berger and Leigh (1989), Braakmann (2011), Currie and Moretti (2003), Cutler and Lleras-Muney (2010), de Walque (2007), Grimard and Parent (2007), Jürges, Reinhold, and Salm (2011), and Lleras-Muney (2005). See also Cutler and Lleras-Muney (2012), Eide and Showalter (2011), and Grossman (2004) for reviews of this line of literature.

3. See also Braakmann (2011) and Jürges, Kruk, and Reinhold (2013). Both use the British compulsory schooling laws – the first paper interacts the laws with the CSE and O-level exams, the second uses biomarkers and self-reported health as measures of outcomes – the first does not find evidence education improves health, the second has results that vary by measure of outcomes.

4. Most papers in this line of literature are on the effects of education on health in developed countries.

5. See, for example, Tempo (1978). See also Government of Indonesia (1985), MPKRI (1978), and some discussions of education policies in Indonesia in Samarakoon and Parinduri (2015).

6. SD Inpres is the shorthand for Sekolah Dasar Instruksi Presiden, which literally means ‘Presidential Instruction’ Primary Schools.

7. See Parinduri (2014) for a discussion of other education policies implemented by the government of Indonesia since Indonesia’s independence in 1945 until mid-1980s.

8. See Frankenberg and Thomas (2000) and Strauss, Witoelar, Sikoki, and Wattie (2009a) for the details of the survey.

9. The word memorisation exercise is done as follows: (1) The interviewer tells the respondent that she will read a list of 10 words that the respondent will need to memorise; (2) then she reads 10 words slowly, around two seconds between each word (for example, the 10 words are hotel, river, tree, skin, gold, market, paper, child, king, book – all in Bahasa Indonesia); (3) she asks the respondent to let her know the words that the respondent remembers in at most two minutes.

10. I construct shaman from a question on whether a person has been to a ‘shaman, wiseman, kyai, Chinese herbalist, masseur, acupuncturist, and so forth’ in the last four weeks. (Kyais are moslem scholars; some Indonesians believe kyais are able to cure diseases.)

11. The graphs in Figures 1 and 2 and the estimates in Table 3 are similar to those in Parinduri (2014).

12. These results, and the second-stage estimates, are similar to those in Parinduri (2014) who examines the effects of the longer school year on educational attainment and employment outcomes later in life.

13. I estimate the system of three equations jointly using the command reg3 (http://www.stata.com/manuals14/rreg3.pdf) in Stata with the 2SLS option to do a two-stage least-square equation-by equation estimation of the three equations. I also use the 3SLS option, which is more efficient than the 2SLS option if the equations are not misspecified; I find similar results (I do not present these results for the sake of brevity).

14. Cutler and Lleras-Muney (2010), for example, find that knowledge and cognitive ability explain 30 per cent of the relation between education and health; they study the relation in the UK and United States, however, not in developing countries. See also Auld and Sidhu (2005).